Vision care insurance can help with costs of regular eye exams, which can help you maintain a good quality of life.
Understand the Importance and Costs of Eye Exams
Eye exams don’t just detect vision problems, but can signal, or help prevent, future health problems. The cost of an eye exam can run as little as $50 and can go up to over $100, depending on who performs the eye exam and on whether or not you have vision care insurance.
The basics of an eye exam
You can have your eye exam performed either by an ophthalmologist or an optometrist. An ophthalmologist, according to allaboutvision.com, is an eye doctor with either an MD (medical doctor) or OD (osteopathic doctor) credential to practice medicine and surgery; an optometrist is an eye specialist with a Doctor of Optometry degree who’s not a medical doctor. The cost of an eye exam is generally lowest (often about $50), when you have it performed by an optometrist at a retail store (like Target or Costco) or at an optical chain. Eye exam cost is highest when conducted by an ophthalmologist in a clinic or an office. Here, the cost of an eye exam can run well over $100.
Doctors generally recommend that you have your eyes examined every one to two years, depending on your age, according to allaboutvision.com. More specifically, if you’re over 60, you should have annual eye exams, while if you’re between the ages of six and 60, you should have an eye exam once every two years. Children under the age of six generally have eye exams at six months of age and then again at three and six.
During an eye exam, the ophthalmologist or optometrist will generally perform the following procedures, according to the Berkeley Eye Center:
- Distance vision test, using a chart with letters that decrease in size
- Eye movement test, as your eyes follow a small light from one side to the other
- Refraction test, using various lenses
- Color blindness test, using cards that have colored dot patterns
- Slit-lamp examination, which provides a magnified view of the eye for better inspection
- Eye pressure test, to screen for glaucoma
- Dilated exam, using drops to dilate the pupils in order to examine the inside of your eyes
The standard eye exam will detect many serious eye problems, including cataracts, which is clouding of the eye’s lens and the main cause of blindness in the world. Also note that even if you’ve had vision-correction surgery, including LASIK, you still need to have a regular eye exam, preferably once a year.
Different types of eye exams
There are different types of eye exams that you may need to undergo in addition to a standard eye exam, depending on your age, family history of eye problems, and overall health. An eye exam for contact lenses is one such test, and it generally costs more than a standard eye exam because it includes the basic eye exam plus the contact lens fitting. The eye exam for contact lenses may also include cornea measurements, pupil and iris measurements, a tear film evaluation (to measure your body’s ability to produce tears), and a test of your eye’s surface to determine if there are any changes caused by the contact lenses.
Other types of eye exams may be necessary when you suffer from a specific medical condition that affects your ability to see properly, like glaucoma (damage to the optic nerve) or diabetes. To detect glaucoma, besides the standard eye pressure test, your doctor will test for optic nerve damage, looking for slight changes that may reveal the beginnings of the eye disease, according to the Mayo Clinic. The glaucoma eye exam cost can run about $100 to $150, unless you have health insurance.
Diabetes sometimes causes damage to the small blood vessels in your retina, eventually leading to blindness if left untreated, states the National Institutes of Health. This type of eye disease is called diabetic retinopathy. The standard eye exam described above is generally used to detect diabetic retinopathy. Diabetics might get coverage for at least one annual eye exam due to their condition, depending on their health insurance or vision insurance plans.
Vision care insurance
Under the Affordable Care Act (ACA, also referred to as Obamacare), all qualified health plans (insurance plans certified by the federal Health Insurance Marketplace) must offer pediatric vision care insurance, including (but not necessarily limited to) an annual eye exam and some related benefits, such as eyeglasses, for all patients under the age of 19.
Qualified health plans also usually cover many eye diseases, including (but not limited to) glaucoma, cataracts, and diabetic retinopathy, because they’re considered to be medical problems and can be billed to your medical health plan.
However, most qualified health plans do not offer adult vision coverage. If you need this benefit, including coverage for eye exam costs plus material benefits (eyeglass lenses, eyeglass frames, partial coverage for LASIK procedures, and so on), you may want to consider purchasing a stand-alone vision care insurance plan. These plans generally cost between $150 and $180 per year, depending where you live. They generally cover 100% of the eye exam cost and of the prescription lenses cost. Frames and contact lenses are usually covered up to $120 each.
You can explore your options for vision insurance plans by clicking the button on the right side of this page. And, we invite you to sign up for our newsletter on the right side of this page as well—it’s filled with health- and insurance-related updates.
This article is for informational purposes only. Nothing in it should be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine. In addition, this information only provides some factors to consider when purchasing insurance and may not reflect the provisions of any particular insurance product. Always carefully check the provisions of any insurance product you have or may consider purchasing.